cholesterol high

5 Strategies to Reduce Cholesterol

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Many people think you need to eat salads and live in the gym to reduce your high cholesterol.  While those things will help, you don’t have to do them 24/7 to see improvements.  You can improve your cholesterol reading by making small, sustainable changes to your lifestyle.  You will have to eat some vegetables, but you won’t have to give up your Saturday night fun-feast filled with jazz and liquor.  

What the “H-E-Double Hockey Sticks” do all the letters mean?

There really is only one type of cholesterol…that’s cholesterol.  You hear all these letters to describe cholesterol but those are carriers.  Think of cholesterol as being a passenger and the two or three letter cholesterol designators as being the vehicles that carry cholesterol throughout the body.  With that said, there are two “vehicles” that make up your total cholesterol reading. 

The first is low-density lipoproteins (LDL).  LDLs can move through artery walls.  Once in, they set off the immune system signaling specific white blood cells.  They ascend on the site causing inflammation…bear in mind some inflammation is good.  These specific white blood cells are repairing the damage from the LDL thus trapping them in place causing plaque buildup in your arteries.  This constricts blood flow, eventually leading to cardiovascular distress. 

Picture a Cheerio straight from a box.  It has a large center and the outside is rigid. Now, picture a Cheerio that’s been sitting in milk for a while.  The center is smaller because it’s soaked up the milk and expanded.  Less milk passes through the center.  The Cheerio is your artery and the milk is LDLs.  The LDLs cause your openings to narrow thus not allowing as much blood to flow through.  Now, hang with me…this gets fun! 

High-density lipoproteins (HDL) are the good kind.  HDLs can actually remove the entrapped LDLs from the arteries allowing for more blood to flow back through them.  What?!  I know, right?  I think it’s pretty sweet myself!

The last number you will usually see is triglycerides (TGs).  TGs are difficult for some to understand because they are not all bad and they aren’t actually cholesterol.  What?!  We get a lot of our daily energy from TGs so in a sense…we need them!  On the flip side, excess TGs are stored as fat in the body and drive your overall TG number up. Bummer. So, just know that we need them, but like anything else…too much of a good thing is no bueno.

Obligatory Cholesterol Facts

cholesterol statistics

High cholesterol is more common than many people think that it is.  The Centers for Disease Control (CDC) reports that 31 million adults have high total cholesterol and 31.7% of adults (or 73.5 million) people have high LDL in the US…yes just the US.  And, fewer than 1 out 3 Americans have their cholesterol under control.  Having untreated high cholesterol puts that individual at twice the risk of developing heart disease, which can lead to heart attack or stroke.  Like many other diseases, high cholesterol is on the rise…in 1980, roughly 5% of the population had high cholesterol.  In 2010, that number was 23%.  In 2016, that number grew to 29%. 

Just having high cholesterol isn’t the only issue.  This condition leads to others as well.  High cholesterol can increase your chances of developing heart disease, gallstones, high blood pressure, peripheral artery disease (which cuts off blood flow to the legs, feet, and kidneys), dementia, and non-alcoholic fatty liver disease (aka fatty liver).  

Silver Lining

We do actually need some cholesterol in our lives.  Cholesterol is used to maintain the delicate structure of our cell membranes to help ensure they’re primed to do their job.  They make steroid hormones like glucocorticoids (which are used in blood sugar regulation), hormones that balance our minerals, and important sex hormones like estrogen, progesterone, and testosterone.  Cholesterol is very important in the vitamin D process as it converts inactive vitamin D to the active form. (Check out my in-depth blog on vitamin D here!)  Bile salts are another important by-product of cholesterol.  We need bile to break down dietary fats.  Without bile, we won’t absorb any of those good quality fats that raise our HDL.

Causes

Why?  Doesn’t matter at this point, does it?  You have it, now let’s lower it.  There are a variety of reason why people have high cholesterol, such as having thyroid issues or it could be hereditary (although only about 1 in 500 have hereditarily high cholesterol).  Lifestyle is probably the driving factor in most cases…what you’re eating, how much you move, your sleep, the amount of stress you have, and what type of environment you live in.  What matters is that you’re here, let’s get you on the path to getting better, mkay? 

1...Food/Diet

Groan.  I know.  But I promised…it’s not all rabbit food all the time. This is the first of 5 things you can do to decrease and maintain a healthy cholesterol level.  In my opinion, this is one of the most important steps…that’s why it’s first!  Let’s break down what you should be eating, because I’m sure you know what you shouldn’t be eating.

1. Whole grains – 100% whole grains like oats, barley, rye, brown rice, and quinoa are packed with fiber.  Not only that, they’re packed with soluble fiber.  There are two types of fiber: soluble and insoluble. 

  • Soluble fiber produces a sludge that slows down digestion so you can feel fuller longer AND absorb all those sweet sweet nutrients.  It also binds to excess cholesterol and helps flush it from the body.  Soluble fiber also ferments in the large intestine causing immune boosting agents to be spread in the body.  Fermentation also creates good bacteria to help balance out the not-so-good bacteria.  It also inhibits new cholesterol production (because we produce a lot on our own). 
  • Insoluble provides bulk to your stool. 

2. Legumes – These are beans, peas, peanuts, etc.  They also have the same fermentation, immune boosting, and cholesterol binding properties that whole grains do.  Why?  Because they have soluble fiber

soluble vs insoluble fiber

3. Red grapefruit – Consuming one whole red grapefruit per day has been shown to decrease total cholesterol and LDL.  A word of caution:  do not consume grapefruit if you’re on a statin.  This is super important because enzymes in the grapefruit can cause either too much or too little of the medication to be absorbed.  There are other medications grapefruit interacts with as well.  Speak with your physician if you’re on medications and want to start eating grapefruit.  But, if you’re not on meds…eat up!

grapefruit statins

4. Cholesterol in food – I internally eye roll at this one every time.  I’m putting it out there for people that want to know but it’s not going to have a large effect for most.  You can certainly reduce the amount of cholesterol you consume by way of foods.  However, decreasing your dietary cholesterol intake by 100 mg will only really decrease your cholesterol reading by about 4 mg/dL.  This equates to “not enough to make a difference.” 

Now, this isn’t to say that all people who reduce their dietary cholesterol aren’t successful.  Approximately 25% of those with high cholesterol will see a significant decrease in the cholesterol readings simply by removing cholesterol-laden foods.  There’s a lot of factors that go into this, therefore it can’t really be isolated only to removing those foods.  For instance, vegans and/or vegetarians.  They don’t consume cholesterol but they eat a lot of vegetables, wholes grains, and beans…all foods that drive down cholesterol.  You picking up what I’m putting down?

5. Eggs – Technically this could fall under the food cholesterol section but that section was getting ridiculously long so I started a new one…because I can.  Dietary cholesterol is easily oxidized meaning when cholesterol meets oxygen, its structure changes…usually for the worse.  The yolk of the egg is where the cholesterol lies.  When consuming eggs, not breaking the yolk (exposing the cholesterol to oxygen) will be key:

  • Not so good = scrambled eggs
  • Getting better = fried (any kind)
  • Best = hard boiled or poached

6. Fats – Man, I could go on and on in this section so I’ll keep it simple.  You must eat fats.  We need them just like we need cholesterol.  Eating a low-fat diet is not always the best course of action.  A low-fat diet comes in handy for individuals with certain medical conditions but for most of the population, fat is good! 

  • Don’t consume trans fats.  These are essentially man-made and drive up LDL while lowering HDL (the opposite of what we’re trying to do).
  • There’s always a lot of talk about saturated fat but not all saturated fat is bad.  Just like the eggs, fat is easily oxidized so preparation and sourcing is key!
  • Red meat falls into the saturated fat section.  If you’re going to eat red meat, ensure you’re getting grass-fed meats from a local butcher.  Grass-fed beef does have a more desirable saturated fat profile.  However, you still have to prepare it in a manner that won’t cause the fat to oxidize.  It gets confusing so it’s easier to just say limit your red meat intake to two times per week.  The serving size should be no larger than the palm of your hand.
  • Polyunsaturated fats help to lower total cholesterol numbers and LDL numbers.  Like other fats, preparation is key.  High temperature cooking such as frying can oxidize these fats, rendering them useless. Polyunsaturated fats are best eaten in their natural state or cooked at a low or moderate temperature.
  • Monounsaturated fats work in the same manner as polyunsaturated fats, however they are more stable at higher temperatures.Nuts and seeds….eat them.  Eat them.  Eat them.  EAT THEM!.  They are packed with healthy fats which will help lower cholesterol levels.  
Healthy fats

7. Meal frequency – Eating smaller, more frequent meals throughout the day help lower overall cholesterol levels as does consistent meal timing.  Various studies have shown that eating one large meal per day or erratic eating (i.e. inconsistent meal times) lowers HDL and increase LDL.  This is the opposite of what we are trying to achieve.  Although why this happens isn’t really known, it’s best to stick as close to a schedule as you can.  You don’t have to eat dinner at the exact same time each day, but within a close range would be helpful.

8. Soy Protein – There are entirely too many myths about soy out there.  Truth be told, I actually used to think soy was bad too.  That was until I got a fancy degree and really started reading studies versus listening to web-based chatter.  Not all soy is the same.  Good soy would be organic soy from tofu, tempeh, soy beans (i.e. edamame), miso, and natto.  Soy is packed with protein and nutrients.  Individuals that replaced animal protein with soy found they reduced their total cholesterol as well as their LDL.  And men, before you ask…soy will not cause you to grow moobs (aka man-boobs).  

9. Garlic – It’s a prebiotic, which means it’s going to ferment in the colon like soluble fiber which will help promote the growth of healthy bacteria and inhibit the production of cholesterol in the body.  Fresh, raw garlic is the best form to consume.  

With all this, just know that a combination of all dietary strategies will have the greatest impact on lowering your total cholesterol and LDL levels while raising HDL levels.

Nutritional therapy - cholesterol
2...Exercise

Short and simple…do it.  It sucks…I totally get it.  Some people (whom I am convinced are aliens) enjoy working out.  I don’t.  It ranks right up there with cooking.  Yes, I am a nutritionist that hates cooking.  Aerobic exercise (aka cardio) can increase your HDL and long-term aerobic exercise can decrease your TGs.  However, ensure you’re adding in weight training as well.  Muscles are good and support your frame as you age.  The current recommendation is 150 minutes per week or 30 minutes per day five days per week.  Or if five days per week is too much to carve out of your schedule, why not do three-one hour sessions per week?  It’s a pain to start but once you get moving, it gets easier each time.  

types of exercise
3...Stress!

Stress is inevitable, especially in the world today.  There’s little we can do about the stress that surrounds us…thoughts of money, employment, politics, family, and health.  What we can control is how we are dealing with this stress.

Benefits of meditation

In a nutshell, when you have a stressor, a response occurs inside your body that releases a series of hormones.  The first gives you energy, the second gives you focus, and the last is cortisol which floods your body with stored glucose so your body can make more energy.  This process is beneficial…if you’re in the midst of an arms deal or perhaps you’re trying to outrun a cheetah.  Realistically, most of us don’t deal with those stressors.  We deal with everyday stressors.  However, the response our body has is no different. 

When we aren’t outrunning something bad, the free glucose the cortisol released does not get used.  The body re-stores the glucose usually around the abdomen. Cortisol kicks off cravings and leads to poor eating habits.  This causes weight gain and can drive up LDLs and TGs.  Not much is known as to why cortisol raises cholesterol levels, but there is a significant link between stress and cholesterol levels. 

One thing you can do to reduce your stress is meditation.  I know you are all eye-rolling at this point.  In reality, you probably already meditate without knowing it. Ever shut your eyes and took a deep breath in and then let it out?  That’s meditation!  It’s not all sitting on the floor cross-legged and saying ohm.  

Meditation

Sleep is another important thing you can do to help lower your stress levels, effectively helping to reduce your cholesterol levels.  Short-term sleep deprivation has little to no effect on your cholesterol levels.  However, prolonged sleep deprivation does. Unfortunately, in post-menopausal women, short-term sleep deprivation can raise LDLs and TGs. 

Additionally, sleep deprivation decreases our food satiety hormone, called leptin, and increases our hunger hormone, called ghrelin.  When this occurs, we have a hard time being satisfied with the foods we eat, have a hard time feeling full, and continue to eat foods in the hopes that we can fill that void.

Sleep deprivation also increases cortisol causing the same effects on your body as stress.  So, what’s a good amount of sleep?  Thank you for asking…it’s seven to nine hours with a median of eight hours.  Some need closer to seven and some need closer to nine.  You may be able to function on less, but can you really? Short-term…maybe.  Long-term…you can’t.  It will eventually catch up to you.

I know that you’re wondering where you’re going to find time to sleep.  That’s part of the stress conundrum we face today.  It really comes down to priorities.  Making yourself a priority to heal and be healthy.  I always tell people...self-care isn’t selfish.  If you don’t take care of yourself now, you may not be able to take care of others later on.

The health benefits of sleep
4.  Supplements/Herbal Concoctions (aka Witch’s Brew)

There are a variety of supplements and herbs that can help in lowering total cholesterol, LDL, and TGs, such as niacin, pantethine, vitamin C, red brewer’s yeast, fish oil, and on and on. I’m not going to dive into this because without knowing what specific medications you’re taking, I’m hesitant to tell you which supplements or herbs you should take.  Why?  I’m so glad you asked.  Even though supplements can be bought off the shelf (same with herbs), that doesn’t mean they are always 100% safe. Supplements and herbs can interact with medications and some medical conditions. Never start taking a supplement or herb without first seeking the advice of your physician or a nutritionist that has gone over your medical history and medication list with you.

Aaaaaaaand lastly...Medications

There are a variety of medications used to help reduce your cholesterol levels.  Statins tend to be the most popular and most effective at lowering the numbers.  Just like any medication, they have their side effects and some feel them much more than others.  Accepting a medication is a personal decision only made by you and your physician.  I do, however, implore individuals that are on statins or have been told they need them to really take a look at their lifestyle and make necessary changes there. This can potentially reduce your dependency on cholesterol lowering medications.  

So, that’s it.  That’s all you have to do to start down the path to lowering your cholesterol.  I know what you’re thinking. “That’s it!  That’s a ton of crap!” Your first read through this blog will seem very overwhelming.  You’ll feel like you’ve already tried something and it didn’t work for you or you’ll feel like there’s no way you can change this or add that.  Decide right now, one food item you can introduce or change from section one.  Do that this week.  Come back and read this blog again.  Then decide on a second food item. Continue this until you’re on the path to a healthier eating pattern.  Now work on the exercise.  Take one to three weeks to fully incorporate movement into your schedule. Then come back and work on destressing.  By then, you’ll be fully committed to changing because you’ve already begun to see improvements in your health and overall well-being.  Use this blog in conjunction with the free wellness guide and you’ll be set.

Oh, did I forget to mention you get a free cholesterol wellness guide?  Click the banner at the top of this page to receive your free guide.  This guide covers everything in this blog but also provides a roadmap for you.  If you commit to following the map, you’re committing to putting your health first.  I promise you, it’s much easier than you think…you only need to commit.  On top of that, I'm also providing free access to the Sprouting Up - Nutrition Knowledge for Your Healthy! Facebook group.  You can lean on others for support and I'll be in there to answer any questions!

Understanding health cholesterol levels

Comment below and let me know your thoughts, struggles, questions, etc.

Remember…health starts from within!

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Sources:

Daley, C. A., Abbott, A., Doyle, P. S., Nader, G. A., & Larson, S. (2010). A review of fatty acid profiles and antioxidant content in grass-fed and grain-fed beef. Nutrition Journal, 9, 10. http://doi.org/10.1186/1475-2891-9-10

Gaby, A. R. (2011). Nutritional medicine. Concord, N.H: Fritz Perlberg Publishing.

High Cholesterol Facts. (2015, March 17). Retrieved August 03, 2017, from https://www.cdc.gov/cholesterol/facts.htm

Koester, V. (2002). Serum cholesterol affects blood pressure regulation. Journal of Human Hypertension, 16(5), 337-343. doi:10.1002/chemv.201500064

O’Keeffe, M., Roberts, A. L., Kelleman, M., RoyChoudhury, A., & St-Onge, M.-P. (2013). No effects of short-term sleep restriction, in a controlled feeding setting, on lipid profiles in normal weight adults. Journal of Sleep Research, 22(6), 10.1111/jsr.12060. http://doi.org/10.1111/jsr.12060

Reed, B., Villeneuve, S., Mack, W., DeCarli, C., Chui, H. C., & Jagust, W. (2014). Low HDL and High LDL Serum Cholesterol Are Associated With Cerebral Amyloidosis. JAMA Neurology, 71(2), 195–200. http://doi.org/10.1001/jamaneurol.2013.5390

Story, C. (2017, April 17). High Cholesterol Comorbidities: What You Need to Know. Retrieved August 03, 2017, from http://www.healthline.com/health/high-cholesterol/treating-with-statins/comorbidities#7

Wang, Y., & Xu, D. (2017). Effects of aerobic exercise on lipids and lipoproteins. Lipids in Health and Disease, 16, 132. http://doi.org/10.1186/s12944-017-0515-5

When high cholesterol is a family affair. (2007, September). Retrieved August 03, 2017, from https://www.health.harvard.edu/newsletter_article/when-high-cholesterol-is-a-family-affair

Sunny Brigham, MS, CNS

I'm Sunny! I'm a board-certified clinical nutritionist with an MS in Clinical Nutrition. I help individuals reduce fatigue, eliminate bloat, and lose weight by healing the digestive tract and balancing hormones. I provide individual and group nutrition consultations nationwide. Join my closed Facebook group today! https://www.facebook.com/groups/140571826548289/

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